Amnestic syndrome of the medial temporal type identifies prodromal AD - A longitudinal study
Amnestic syndrome of the medial temporal type identifies prodromal AD - A longitudinal study
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DOI：
10.1212/01.wnl.0000279336.36610.f7
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发表时间：
2007-11-06
期刊：
影响因子：
9.9
通讯作者：
Dubois, B.
中科院分区：
文献类型：
--
作者：
Sarazin, M.;Berr, C.;Dubois, B.
目的：比较评估不同认知域的测试在轻度认知障碍（MCI）患者中识别前驱阿尔茨海默病（AD）的能力。背景：考虑到内侧颞叶的早期累及，一种早熟和特定的记忆障碍模式可能被期望用于识别前驱AD。方法：对251例轻度认知障碍患者在基线时进行标准化神经心理学测试，包括言语情景记忆的自由和线索选择性回忆提醒测试（FCSRT）；本顿视觉记忆保留测验；Deno 100和语言流利度；串行数字学习测验和巴德利工作记忆双任务；韦氏成人智力量表（WAIS）概念阐述的相似性；以及Stroop测试，Trail Making测试和WAIS数字符号执行功能测试。每隔6个月对患者进行长达3年的随访，以确定哪些患者转化为阿尔茨海默病，哪些患者在一段时间内保持稳定。统计分析基于受试者工作特征曲线和Cox比例风险模型。结果：共有59名受试者转化为AD痴呆。FCSRT是诊断前驱AD最敏感、最特异的检测方法。自由回忆率为17/48，总回忆率为40/48，线索敏感性指数（检索语义线索的有效性百分比）低于71%。结论：自由和提示选择性回忆提醒测试定义的内侧颞叶型遗忘综合征能够区分早期阿尔茨海默病患者和轻度认知障碍非转换者。
Objective: To compare the power of tests assessing different cognitive domains for the identification of prodromal Alzheimer disease ( AD) among patients with mild cognitive impairment ( MCI).Background: Given the early involvement of the medial temporal lobe, a precocious and specific pattern of memory disorders might be expected for the identification of prodromal AD.Methods: A total of 251 patients with MCI were tested at baseline by a standardized neuropsychological battery, which included the Free and Cued Selective Recall Reminding Test ( FCSRT) for verbal episodic memory; the Benton Visual Retention Test for visual memory; the Deno 100 and verbal fluency for language; a serial digit learning test and the double task of Baddeley for working memory; Wechsler Adult Intelligence Scale ( WAIS) similarities for conceptual elaboration; and the Stroop test, the Trail Making test, and the WAIS digit symbol test for executive functions. The patients were followed at 6-month intervals for up to 3 years in order to identify those who converted to AD vs those who remained stable over time. Statistical analyses were based on receiver operating characteristic curve and Cox proportional hazards models.Results: A total of 59 subjects converted to AD dementia. The most sensitive and specific test for diagnosis of prodromal AD was the FCSRT. Significant cutoff for the diagnosis was 17/48 for free recall, 40/48 for total recall, and below 71% for index of sensitivity of cueing (% of efficacy of semantic cues for retrieval).Conclusions: The amnestic syndrome of the medial temporal type, defined by the Free and Cued Selective Recall Reminding Test, is able to distinguish patients at an early stage of Alzheimer disease from mild cognitive impairment non-converters.